Are poor people less likely to be healthy than rich people?

Higher income and social status are linked to better health. There is strong evidence to support this. Even more notably, people’s health is affected by how wide the difference in income is between the richest and poorest members of the society. So while people with lower income and social status have less control and fewer choices in their lives, this is even more the case when the income gap in the society is very wide.

How does this affect Canadians?

One Canadian study found that men in the top 20 per cent income bracket live on average six years longer than those in the bottom 20 per cent. For women, the difference was 3 years.

The rate of infant death is the most dramatic illustration of this trend. While there has been a considerable drop in the infant death rate over the last 20 years, babies born in poor neighbourhoods continue to have a greater risk of death than infants from wealthy neighbourhoods – in fact, their risk of dying is almost double.

There are other striking examples of how income affects Canadian children’s health and development.

• According to a national study of poverty, family stress, parenting, and neighbourhood social capital, Canadian children living in poverty are prone to exhibit hyperactivity and inattention to a greater degree than more advantaged children (Burnstein, 2005).
• Living in poverty tends to compromise the immediate and long-term health and development of children (CPHI, 2004), such that they are more likely to suffer physical impairments, disabilities, and accidents (Burnstein 2005).
• Students in less affluent families tend to be exposed to a greater degree of socioeconomic and environmental risks that result in lower grades and a greater number of absences, a finding consistent throughout the literature (Gutman et al., 2003; Pagani et al., 1999).

This difference in health between the rich and poor does not just affect those with the highest and lowest incomes; it actually occurs on a gradient. In other words, people in the highest income group are healthier than those at the next level down, and this pattern continues to the lowest income group.

These gradients have persisted over a long period of time, even though the principal causes of death and disease have changed considerably. In other words, no matter what diseases people suffer and die from, the poorer people are, the more likely they will suffer or die from them.

Why is higher income linked to better health?

If it were just a matter of the poorest people having poor health and the richest having the best health, then health could be linked mainly to living conditions in the environment. However, since this effect occurs across the entire range of income, social class and living conditions, the relationship is clearly more complex than that.

For example, research shows that the degree of control that people have over their lives is related to their wealth and their health. This is especially true when it comes to dealing with stresses that they encounter, and the choices that they have. People with more money, education and status tend to have more control and choices over things like where they live, and their salary and working conditions.

Recent studies also show that this works biologically as well as socially in people’s lives. Their bodies are more vulnerable to disease when people have little control and few options, and have trouble coping with stress as a result. This is because their immune and hormonal systems will weaken in response to these unfavourable conditions.

For a long time we have heard people talk about the connection between people’s living conditions and their health. However, until recently there was little hard evidence to support these assumptions. Now, there are research findings demonstrating not only that economic conditions influence health, but also how this happens.

References

Jin R.L.; Shah, C.P. & Svoboda, T.J. The Impact of Unemployment on Health: A Review of the Evidence. Canadian Medical Association Journal, September, 1995, 153(5), p 529-540.

Burstein, M. (2005). “Combating the Social Exclusion of At-Risk Groups.” Policy Research
Initiative, Government of Canada.

Gutman, L., A. Sameroff and R. Cole. (2003). “Academic Growth Curve Trajectories From 1st
Grade to 12th Grade: Effects of Multiple Social Risk Factors and Preschool Child Factors.”
Developmental Psychology 39 (4): 777-790.

Pagani, L., B. Boulerice, F. Vitaro and R. Tremblay. (1999). “Effects of Poverty on Academic
Failure and Delinquency in Boys: A Change and Process Model Approach.” Journal of Child
Psychology and Psychiatry 40 (8): 1209-1219.